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São Paulo, Brazil

Pedro H.S.P.,Instituto Adolfo Lutz | Pedro H.S.P.,Sao Paulo State University | Nardi S.M.T.,Instituto Adolfo Lutz | Pereira M.I.T.,Instituto Adolfo Lutz | And 10 more authors.
Memorias do Instituto Oswaldo Cruz | Year: 2015

Drug-resistant tuberculosis (TB) is a growing global threat. Approximately 450,000 people developed multidrug-resistant TB worldwide in 2012 and an estimated 170,000 people died from the disease. This paper describes the sociodemographic, clinical-epidemiological and bacteriological aspects of TB and correlates these features with the distribution of anti-TB drug resistance. Mycobacterium tuberculosis (MT) cultures and drug susceptibility testing were performed according to the BACTEC MGIT 960 method. The results demonstrated that MT strains from individuals who received treatment for TB and people who were infected with human immunodeficiency virus were more resistant to TB drugs compared to other individuals (p < 0.05). Approximately half of the individuals received supervised treatment, but most drug-resistant cases were positive for pulmonary TB and exhibited positive acid-fast bacilli smears, which are complicating factors for TB control programs. Primary healthcare is the ideal level for early disease detection, but tertiary healthcare is the most common entry point for patients into the system. These factors require special attention from healthcare managers and professionals to effectively control and monitor the spread of TB drug-resistant cases. © 2015, Fundacao Oswaldo Cruz. All rights reserved. Source

de Almeida I.A.Z.C.,Instituto Adolfo Lutz | Peresi J.T.M.,Instituto Adolfo Lutz | Alves E.C.,Instituto Adolfo Lutz | Marques D.F.,Instituto Adolfo Lutz | And 5 more authors.
Brazilian Journal of Infectious Diseases | Year: 2015

Objectives: The aim of this study is to report the occurrence of the first outbreak of food poisoning caused by Salmonella Alachua in Brazil, as well as the antimicrobial susceptibility and the genetic relatedness of Salmonella Alachua strains isolated from clinical and food samples. Material and methods: To elucidate the outbreak, an epidemiological investigation was carried out, and two samples of common food were tested - mayonnaise salad and galinhada (a traditional Brazilian dish of chicken and rice) - according to the Compendium of methods for the microbiological examination of foods. Five stool samples were tested employing classic methods for the isolation and identification of enterobacteria. Strains of Salmonella were characterized for antibiotic susceptibility according to the Clinical and Laboratory Standards Institute guidelines (2013), and submitted to pulsed-field gel electrophoresis analysis, performed according to the Centers for Disease Control and Prevention PulseNet protocol. Results: A total of 94 people were interviewed after ingesting the food, 66 of whom had become ill. A 60-year old female patient who was hospitalized in a serious condition, developed septic shock and died two days after consuming the food. The presence of Salmonella Alachua was confirmed in all the analyzed stool samples, and in the two types of food. The five strains showed higher than minimum inhibitory concentration values of nalidixic acid (≥256. μg/mL) and reduced ciprofloxacin susceptibility (minimum inhibitory concentration. = 0.5. μg/mL). The pulsed-field gel electrophoresis analysis revealed indistinguishable patterns in S. almonella Alachua strains isolated from clinical and food samples. Conclusion: The data presented herein confirm the foodborne disease outbreak. They also allowed for the identification of the source of infection, and suggest that products from poultry are potential reservoirs for this serotype, reinforcing the importance of warning consumers about the danger of possible contamination. © 2015 Elsevier Editora Ltda. Source

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